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General NPI Number Information
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NPI Number | 1881963122
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Entity Type | Individual
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Provider Name | HEATHER CALHOUN QUAILE NP-C
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Gender | Female
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Dates
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Enumeration Date | 12/15/2011
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Last Update Date | 06/13/2020
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Provider Practice Location Address
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Address Line | 3233 S CHEROKEE LN BLDG 1000
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City | WOODSTOCK
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State | GA
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Zip | 30188-4461
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Country | US
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Telephone | 678-673-3953
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Fax | 678-487-3953
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Provider Business Mailing Address
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Address Line | 411 WILD IRIS LN
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-6282
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Country | US
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Telephone | 757-470-4863
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | RN234874
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License Number State | GA
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